Incidence of Venous Thromboembolism, Risk Factors and Prophylaxis in Hospitalized Patients in the South West Region of Cameroon

Figures & data

Table 1 Socio-Demographic Characteristics

Variables	Medical Unit (N=147)	Surgical Unit (N=167)	Total (N=314)
Age (years)
Mean age ± SD	53.7 ± 16.9	40.6 ± 16.4	46.7 ± 17.9
	Frequency n (%)	Frequency n (%)	Frequency n (%)
≤40	34 (23.1)	99 (59.3)	133 (42.4)
41–60	60 (40.8)	42 (25.2)	102 (32.5)
61–74	34 (23.1)	17 (10.2)	51 (16.2)
≥75	19 (12.9)	9 (5.4)	28 (8.9)
Sex
Female	77 (52.4)	108 (64.7)	185 (58.9)
Male	70 (47.6)	59 (35.3)	129 (41.1)
Occupation
Unemployed	44 (29.9)	47 (28.1)	91 (29.0)
Employed	103 (70.1)	120 (71.9)	223 (71.0)

Figure 1 Flow chart of patient recruitment.

Table 2 Reasons for Admission in the Medical Unit (N=147)

Reasons of Hospitalization	Frequency (n)	Percentage
Neurological disease*	52	35.4
Infectious diseases^§	43	29.3
Cardiovascular disease^†	29	19.7
Renal disease	12	8.2
Endocrine/metabolic disease	14	9.5
Gastrointestinal/hepatobiliary disease	14	9.5
Malignancy (active)	7	4.8
Rheumatological disease	7	4.8
Haematological diseases	6	4.1

Notes: ^†Cardiovascular diseases included acute heart failure, acute myocardial infarction + other cardiovascular diseases. *Neurological disease included stroke + other neurological diseases. §Infectious diseases included pulmonary infection + other infectious diseases.

Table 3 Reasons for Admission to the Surgical Unit (N=167)

Reasons of Admission	Frequency (n)	Percentage
Major surgery	70	41.92
Other surgical conditions^†	28	16.77
Orthopaedic trauma*	28	16.76
Minor surgery	15	8.98
Cellulitis of the limbs	10	5.99
Awaiting an elective surgery	7	4.19
Major trauma but surgery not done	7	4.19
Curative arthrotomy	1	0.60

Notes: ^†Other surgical conditions included conditions such as diabetic feet, burns, ENT pathologies, etc. *Orthopaedic trauma included pelvis or lower limb fractures + other orthopaedic trauma.

Table 4 Risk Factors of VTE Among Patients on Admission

Risk Factors	Medical	Surgical	P-value	Total
	(N=147)	(N=167)		(N=314)
Personal history of DVT/PE	–	1(0.60)	0.266	1(0.32)
Personal history of recent myocardial infarction (<1 month)	4 (2.72)	–	0.266	4 (1.27)
Family history of DVT/PE	1 (0.68)	2 (1.20)	0.349	3 (0.96)
Personal history of stroke (≤ 1 month)	5 (3.40)	1 (0.60)	0.045	6 (1.91)
Varicose veins	2 (1.36)	4 (2.40)	0.272	6 (1.91)
Malignancy	4 (2.72)	2 (1.20)	0.182	6 (1.91)
Prior history of major surgery (<1 month)	3 (2.04)	4 (2.40)	0.425	7 (2.23)
History of unexplained stillborn infant, recurrent spontaneous abortions	2 (1.36)	10 (5.99)	0.174	12 (3.82)
Oral contraceptive	5 (3.40)	5 (2.99)	0.421	10 (3.18)
Chronic pulmonary disease	15 (10.20)	2 (1.20)	0.0002	17 (5.41)
Chronic heart failure	19 (12.93)	2 (1.20)	<0.0001	21 (6.69)
Obesity	12 (8.16)	24 (14.37)	0.044	36 (11.46)
Pregnancy/postpartum (<1 month)	1 (0.68)	40 (23.95)	<0.0001	41 (13.06)
Swollen legs	34 (19.77)	35 (24.65)	0.155	69 (21.97)
Long-term immobility	45 (30.61)	30 (17.96)	0.005	75 (23.89)
Age >40 years	114 (77.55)	67 (40.12)	<0.0001	181 (57.64)

Note: The percentages add more than 100 since a patient could have one or more risk factor.

Abbreviations: DVT, deep venous thrombosis; PE, pulmonary embolism.

Table 5 Risk Factors of VTE Among Patients After Admission

Risk Factors	Medical	Surgical	p-value	Total
	(N=147)	(N=167)		(N=314)
Immobile with bathroom privileges	47 (31.97)	52 (31.14)	0.437	99 (31.53)
Confined to bed (>72hours)	49 (33.33)	45 (26.95)	0.111	94 (29.94)
Complete immobilization	18 (12.24)	8 (4.79)	0.009	26 (8.28)
Immobilisation plaster cast	–	3 (1.80)	0.075	3 (0.96)
Mechanical ventilation	6 (4.08)	3(1.80)	0.126	9 (2.87)
Central venous access	5 (3.40)	1 (0.60)	0.468	6 (1.91)
Admitted to the ICU	5 (3.40)	6 (3.59)	0.437	11 (3.50)

Table 6 Thromboprophylaxis Coverage in the At-Risk Patients

	Medical	Surgical	TOTAL	P-value
	(n=139)	(n=155)	(n=294)
Pharmacological	22 (15.83)	34 (22.58)	57 (19.39)
LMWH	17 (12.23)	32 (20.65)	49 (16.67)	0.033
Anti-vitamin K	3 (2.16)	1 (0.65)	4 (1.36)	0.156
Rivaroxaban	2 (1.44)	2 (1.29)	4 (1.36)	0.452
UFH	–	–	–	–
Other	–	–	–	–
Anticoagulant
Non-pharmacological	4 (2.88)	35 (25.16)	39 (13.27)
Early ambulation	4 (2.88)	35 (25.16)	39 (13.27)	<0.0001
IPC	–	–	–	–
GCS	–	–	–	–
Total	26 (18.71)	70 (45.16)	96 (32.65)	<0.0001

Abbreviations: LMWH, low molecular weight Heparin; UFH, unfractionated heparin, GCS, graded compression stocking; IPC, intermittent pneumatic compression.

Table 7 Contraindications to Anticoagulant Prophylaxis

Contraindications	Medical	Surgical	Total	P-value
	(n=139)	(n=155)	(n=294)
Thrombocytopenia (<100,000 platelets/mL)	1 (0.71)	1 (0.65)	2 (0.68)	0.468
Active gastrointestinal bleeding	1 (0.71)	–	1 (0.34)	0.234
Hepatic impairment	1 (0.71)	–	1 (0.34)	0.234
Significant renal impairment (Ccr<30mL/min)	7 (5.04)	–	7 (2.38)	0.002
Bleeding at hospital admission	3 (2.16)	6 (3.87)	9 (3.06)	0.220
Intracranial haemorrhage	8 (5.76)	2 (1.29)	10 (3.40)	0.019
Total	21 (15.12)	9 (5.81)	30 (10.20)	0.004